Telephone-assisted, parent-mediated CBT for rural Latino youth with anxiety: A feasibility trial.

OBJECTIVE: In this study, we tailor a child anxiety cognitive-behavior therapy (CBT) program to fit the needs of rural Latino/a Spanish-speaking families and examine the feasibility, acceptability, tolerability, and safety of this intervention using 2 modes of service delivery. METHOD: Children (n = 31; age 8-13) with anxiety disorders were recruited from primary care settings and randomized to 1 of 2 modes of parent-mediated CBT bibliotherapy: (1) telephone-delivered, therapist-assisted bibliotherapy (TTB; n = 15), and (2) a more minimal contact, self-directed, bibliotherapy condition (SB; n = 16). Independent evaluators administered a diagnostic interview at baseline and posttreatment; demographic and engagement-related questionnaires were also administered. RESULTS: In the TTB group, 10 of 15 parents (66.7%) completed the requisite number of therapist-assisted bibliotherapy sessions, and in the SB group, 4 of 16 parents (25%) completed the requisite number of self-directed bibliotherapy modules; this comparison was significant, χ2(1) = 5.43, p = .02. In the TTB condition, treatment length and session duration were longer than reported in previous studies. Barriers that were most strongly endorsed were stressors and obstacles competing with treatment, as well as treatment demandingness. Findings revealed good satisfaction across the conditions, although ratings were significantly higher in the TTB group, F = 5.67, p = .028. Remission rates (i.e., no anxiety disorder) for those that provided posttreatment data (N = 25) were 50% and 36% for the TTB and SB groups, respectively, χ2(1) = .465, p = .50. CONCLUSIONS: Implications of these feasibility findings and suggestions for future research are discussed. (clinicaltrials.gov unique identifier: NCT01491880). (PsycINFO Database Record

Delivering CBT to Rural Latino Children with Anxiety Disorders: A Qualitative Study.

Qualitative methods were used to understand community perspectives about ways to deliver cognitive behavior therapy (CBT) to rural Latino youth with anxiety. First, four focus groups were conducted with 28 bilingual Latino mental health providers to examine perceptions of CBT using telephone based, therapist supported bibliotherapy, and bibliotherapy without therapist support. Second, qualitative interviews were conducted with 15 Latino parents from a rural community to better understand attitudes toward CBT, and modes of service delivery. Qualitative findings revealed that parents were mostly positive about psychotherapy, and the core elements of CBT for anxiety. However, both parents and providers emphasized the need for adaptations to address practical and perceived barriers to treatment, such as time, convenience, homework, and literacy. Many parents spoke favorably of a telephone-based approach that could address many of their perceived barriers, while providers were expressed more negative views. Such findings are important for data-driven treatment development efforts.

Fetal Endoscopic Tracheal Intubation: A New Fetoscopic Procedure to Ensure Extrauterine Tracheal Permeability in a Case with Congenital Cervical Teratoma.

Congenital neck masses are associated with high perinatal mortality and morbidity secondary to airway obstruction due to a mass effect of the tumor with subsequent neonatal asphyxia and/or neonatal death. Currently, the only technique designed to establish a secure neonatal airway is the ex utero intrapartum treatment (EXIT) procedure, which involves neonatal tracheal intubation while fetal oxygenation is maintained by the uteroplacental circulation in a partial fetal delivery under maternal general anesthesia. We present a case with a giant cervical teratoma and huge displacement and compression of the fetal trachea that was treated successfully at 35 weeks of gestation with a novel fetoscopic procedure to ensure extrauterine tracheal permeability by means of a fetal endoscopic tracheal intubation (FETI) before delivery. The procedure consisted of a percutaneous fetal tracheoscopy under maternal epidural anesthesia using an 11-Fr exchange catheter covering the fetoscope that allowed a conduit to introduce a 3.0-mm intrauterine orotracheal cannula under ultrasound guidance. After FETI, a conventional cesarean section was performed uneventfully with no need for an EXIT procedure. This report is the first to illustrate that in cases with large neck tumors involving fetal airways, FETI is feasible and could potentially replace an EXIT procedure by allowing prenatal airway control.

Silver nanoparticles induce a non-immunogenic tumor cell death.

Immunogenic cell death (ICD) is a form of cell death characterized by the release of danger signals required to trigger an adaptive immune response against tumor-associated antigens. Silver nanoparticles (AgNP) display anti-proliferative and cytotoxic effects in tumor cells, but it has not been previously studied whether AgNP act as an ICD inductor. The present study evaluated the in vitro release of calreticulin as a damage-associated molecular pattern (DAMP) associated with the cytotoxicity of AgNP and their in vivo anti-cancer effects. In vitro, mouse CT26 colon carcinoma and MCA205 fibrosarcoma cells were exposed to AgNP and then cell proliferation, adhesion, and release of calreticulin were determined. The results indicated there were time- and concentration-related anti-proliferative effects of AgNP in both the CT26 and MCA205 lines. Concurrently, changes in cell adhesion were detected mainly in the CT26 cells. Regarding DAMP detection, a significant increase in calreticulin was observed only in CT26 cells treated with doxorubicin and AgNP; however, no differences were found in the MCA205 cells. In vivo, the survival and growth of subcutaneous tumors were monitored after vaccination of mice with cell debris from tumor cells treated with AgNP or after intra-tumoral administration of AgNP to established tumors. Consequently, anti-tumoral prophylactic immunization with AgNP-dead cells failed to protect mice from tumor re-challenge; intra-tumor injection of AgNP did not induce a significant effect. In conclusion, there was a noticeable anti-tumoral effect of AgNP in vitro in both CT26 and MCA205 cell lines, accompanied by the release of calreticulin in CT26 cells. In vivo, immunization with cell debris derived from AgNP-treated tumor cells failed to induce a protective immune response in the cancer model mice. Clearly, further research is needed to determine if one could combine AgNP with other ICD inducers to improve the anti-tumor effect of these nanoparticles in vivo.

[Foodborne disease outbreaks surveillance in Chile]. / Vigilancia de brotes de enfermedades transmitidas por alimentos en Chile.

BACKGROUND: Foodborne disease outbreaks are one of the main health problems globally, having an extensive impact on human welfare. The World Health Organization considers them as the main cause of morbidity and mortality in developing countries, and responsible for high levels of loss of productivity in developed countries. AIM: To describe the epidemiology of foodborne disease outbreaks according to data contained in an automated surveillance system. METHOD: Descriptive observational study of notified outbreaks from the surveillance system, between 2005 and 2010 in Chile. The information was based on etiology, temporal and spatial distribution, and epidemiologic description of outbreaks during this period. RESULTS: There were 5,689 notified outbreaks. Most of them occurred during 2006 (1,106 outbreaks, rate 6.7 per 100,000 inhabitants) and 2008 (1,316 outbreaks, rate 7.9 per 100, 000 inhabitants) with an increase during summer. Fifty four percent occurred in the Metropolitan region. The group aged 15 to 44 years old, was the most affected one. Sixty four percent of the outbreaks had the food involved registered, of which fish and fishery products reached 42%. An 81% of the outbreaks did not have a precise etiologic diagnosis. Of all patients involved, 97% were outpatients, 3,2% were hospitalized patients, and 0,1% died. Only 49% of the outbreaks had information about the lack of food safety, with a 34,1% related to food handling procedures. CONCLUSIONS: Through the information on the epidemiology of foodborne diseases obtained by the Chilean surveillance system, appropriate control measures could be taken.

[Epidemiological and clinical characteristics of influenza A (H1N1) 2009 at San Felipe, Valparaiso Region, Chile: June-August 2009]. / Caracterización epidemiológica y clínica de la infección por influenza A (H1N1) 2009 en San Felipe, Región de Valparaíso, Chile: Junio a agosto 2009.

In order to understand the clinical and epidemiological aspects of infection with the AH1N1 influenza virus in Chile, a prospective study in the city of San Felipe was undertaken. It analyses the trends in consultations for respiratory causes in three primary care centers and hospital discharges by comparing data from years 2008 and 2009 until epidemiological week 37.It also includes a study of cases of ILI / SARI (influenza like disease/severe acute respiratory disease) in which viruses were detected by direct immunofluorescence (DIF) of nasopharyngeal aspirates and by real-time polymerase chain reaction in the case of influenza A (H1N1) 2009. A household survey was conducted in those cases with confirmed A (H1N1) infection, to identify contacts and history related to influenza virus transmission. The results indicate that the behavior of the pandemic was similar to that observed in the rest of the country, with an increase in emergency room visits for ILI. The most affected age group was from 5 to 14 years (26.5 per thousand inhabitants) and the least affected 60 years or older (1.2 per thousand). A 2.78% of the cases corresponded to SARI and the fatality rate was 0.11%.

Food Consumption and Metabolic Risks in Young University Students.

The purpose of this study was to analyze the association between components of the diet, metabolic risks, and the serum concentrations of adiponectin and interleukin-6 (IL-6). With prior informed consent, an analytical cross-sectional study was carried out with 72 students in their first year of university. The subjects had a mean age of 19.2 ± 1.0 years and body mass index of 23.38 ± 4.2, and they were mainly women (80.6%). Sociodemographic, anthropometric, and dietary data and metabolic risk factors were evaluated, and biochemical parameters and adipocytokines were also considered. The data were analyzed using means, ranges, and correlations, as well as principal components. In general, the protein, fat, and sodium intake were higher than the international dietary recommendations, and deficiencies in vitamins B5 and E, potassium, phosphorus, selenium, and zinc were observed. The most frequently observed metabolic risks were insulin resistance and hypoalphalipoproteinemia. IL-6 was positively correlated with lipid and protein intake. Adiponectin showed a positive correlation with high-density lipoprotein and a negative correlation with insulin, weight, and waist, while the adiponectin pattern was similar to that of vitamins E and A, which decreased with increasing intake of calories, macronutrients, and sodium. In general, a hypercaloric diet that was high in protein, fat, and sodium and deficient in vitamins, mainly fat-soluble, was associated with a lower concentration of adiponectin and a higher concentration of IL-6, which favor the presence of metabolic risks, including insulin resistance. Intervention studies are required to evaluate the dietary intake of metabolic markers in young people without comorbidities, which will lay the foundation for implementing prevention strategies.

Incidence of subarachnoid haemorrhage in the Aconcagua Valley, Chile: a community-based, prospective surveillance project.

BACKGROUND: An epidemiological surveillance project was set up in Central Chile to detect cases of subarachnoid haemorrhage (SAH) and its incidence. METHODS: Community-based prospective surveillance project carried out between 1 July 2000 and 30 June 2003, in the Aconcagua Valley in Central Chile. The authors ascertained all possible cases using multiple overlapping sources. Incidence rates were age-sex-adjusted. RESULTS: The authors identified 33 first-ever cases; 19 were women. The mean age (SD, range) was 50.7 (17.9, 16 to 82). The incidence per 100,000 age-sex adjusted to the world population was 5.1 (4.4 men, 5.6 women). The 30-day case-death rate was 54.5% (95% CI 38.0 to 70.2), and the prehospital death rate 21.2% (95% CI 10.7 to 37.7). CONCLUSIONS: The incidence rate in Aconcagua is notably similar to that reported previously in Northern Chile and lower than in many high-income western populations. The lower incidence rates found in these two Chilean populations might be due to their younger age. A trend towards a higher 30-day case-death rate found in Central Chile is possibly associated with its higher rurality and therefore lesser accessibility to preventive measures and medical care.

Toxicity of silver nanoparticles in mouse bone marrow-derived dendritic cells: Implications for phenotype.

Silver nanoparticles (AgNP) are one of the most studied nanoparticles due to their anti-bacterial, -fungal, -viral, -parasitic, and -inflammatory properties. This raises the need to evaluate the toxicity and biological effects of AgNP in the immune system in order to develop new safer biomedical products. In this study, an AgNP formulation currently approved for veterinary applications was applied to mouse bone marrow-derived dendritic cells (BMDC), considered important antigen-presenting cells of the immune system, to evaluate cytotoxicity, genotoxicity, and any significant influence on expression of cellular markers associated with BMDC phenotype and maturation status. The results showed that after 12 h of AgNP exposure, a significant decrease in BMDC viability occurred at the highest concentration tested (1.0 µg AgNP/ml) and at lower doses, the cells maintained membrane integrity and metabolic activity. DNA damage was not significant with any AgNP level aside from the 1.0 µg AgNP/ml level. Regarding phenotype, no differences in expression of CD40 (co-stimulatory molecule highly present in mature BMDC) or in CD273 (a marker for inhibitory T-cell response) were observed. The current results showed that the toxicity of this AgNP formulation was dose-related. The findings also suggest BMDC could maintain structural conservation of co-stimulatory/co-inhibitory surface molecules after 12 h of exposure to this AgNP. This work represents the first step in identifying the toxic effects of this AgNP formulation on dendritic cells.

Conocimientos sobre medidas de bioseguridad ante la COVID-19 en estudiantes de Enfermería / Knowledge about biosecurity measures against COVID-19 in nursing students

Fundamento: los riesgos que implica el quehacer de los profesionales de la salud en el ejercicio de su práctica cotidiana demandan incorporar los elementos concernientes a la bioseguridad a sus funciones. Objetivo: determinar el nivel de conocimiento y la aplicación de las normas de bioseguridad en estudiantes de enfermería ante la COVID-19. Métodos: se realizó un estudio descriptivo transversal durante el mes de octubre de 2020 en el Hospital Clínico-Quirúrgico "Comandante Faustino Pérez Hernández" y el Hospital Pediátrico "Eliseo Noel Camaño" de Matanzas. Se utilizaron métodos teóricos: histórico-lógico e inductivo-deductivo; y empíricos: cuestionario y el análisis documental. Resultados: a través de la aplicación del cuestionario se obtuvo que el 100 % de los estudiantes tienen un adecuado conocimiento sobre el lavado y secado de las manos, el 83,3 % mostró conocimientos adecuados sobre el uso de equipos de protección personal, mientras que el 100 % conoce el uso del nasobuco en la atención a pacientes con infección respiratoria, además se pudo conocer que el 55,5 % hacen uso de los medios de protección siempre, y el 45,5 % solo lo usan algunas veces. Conclusiones el nivel de conocimiento y la aplicación de las normas de bioseguridad en estudiantes de enfermería ante la COVID-19 fueron en su mayoría adecuados, lo que implica diseñar una capacitación sobre el tema dirigida a aquellos que la necesiten.

Background: the risks involved in the work of health professionals in the exercise of their daily practice demand the incorporation of elements concerning biosafety into their functions. Objective: to determine the level of knowledge and the application of biosafety standards in nursing students while facing COVID-19. Methods: a cross-sectional descriptive study was carried out during the month of October 2020 at the "Comandante Faustino Pérez Hernández" Clinical-Surgical Hospital and the "Eliseo Noel Camaño" Pediatric Hospital in Matanzas. Theoretical methods were used: historical-logical and inductive-deductive; and empirical ones: questionnaire and documentary analysis. Results: through the implentation of the questionnaire, it was obtained that 100% of the students have adequate knowledge about washing and drying their hands, 83.3% showed adequate knowledge about the use of personal protective equipment, while 100% know the use of the facemask in the care of patients with respiratory infection, in addition it was possible to know that 55.5% always use the means of protection, and 45.5% only use it sometimes. Conclusions: the level of knowledge and the application of biosafety standards in nursing students before COVID-19 was mostly adequate, which implies designing training on the subject aimed at those who need it.

Adhesion, proliferation, and apoptosis in different molecular portraits of breast cancer treated with silver nanoparticles and its pathway-network analysis.

BACKGROUND: Silver nanoparticles (AgNPs) have attracted considerable attention due to the variety of their applications in medicine and other sciences. AgNPs have been used in vitro for treatment of various diseases, such as hepatitis B and herpes simplex infections as well as colon, cervical, and lung cancers. In this study, we assessed the effect on proliferation, adhesion, and apoptosis in breast cancer cell lines of different molecular profiles (MCF7, HCC1954, and HCC70) exposed to AgNPs (2-9 nm). METHODS: Breast cancer cell lines were incubated in vitro; MTT assay was used to assess proliferation. Adhesion was determined by real-time analysis with the xCELLingence system. Propidium iodide and fluorescein isothiocyanate-Annexin V assay were used to measure apoptosis. The transcriptome was assessed by gene expression microarray and Probabilistic Graphical Model (PGM) analyses. RESULTS: The results showed a decreased adhesion in breast cancer cell lines and the control exposed to AgNPs was noted in 24 hours (p≤0.05). We observed a significant reduction in the proliferation of MCF7 and HCC70, but not in HCC1954. Apoptotic activity was seen in all cell lines exposed to AgNPs, with an apoptosis percentage of more than 60% in cancer cell lines and less than 60% in the control. PGM analysis confirmed, to some extent, the effects of AgNPs primarily on adhesion by changes in the extracellular matrix. CONCLUSION: Exposure to AgNPs causes an antiproliferative, apoptotic, and anti-adhesive effect in breast cancer cell lines cultured in vitro. More research is needed to evaluate the potential use of AgNPs to treat different molecular profiles of breast cancer in humans.

Toxicity of silver nanoparticles in biological systems: Does the complexity of biological systems matter?

Currently, nanomaterials are more frequently in our daily life, specifically in biomedicine, electronics, food, textiles and catalysis just to name a few. Although nanomaterials provide many benefits, recently their toxicity profiles have begun to be explored. In this work, the toxic effects of silver nanoparticles (35nm-average diameter and Polyvinyl-Pyrrolidone-coated) on biological systems of different levels of complexity was assessed in a comprehensive and comparatively way, through a variety of viability and toxicological assays. The studied organisms included viruses, bacteria, microalgae, fungi, animal and human cells (including cancer cell lines). It was found that biological systems of different taxonomical groups are inhibited at concentrations of silver nanoparticles within the same order of magnitude. Thus, the toxicity of nanomaterials on biological/living systems, constrained by their complexity, e.g. taxonomic groups, resulted contrary to the expected. The fact that cells and virus are inhibited with a concentration of silver nanoparticles within the same order of magnitude could be explained considering that silver nanoparticles affects very primitive cellular mechanisms by interacting with fundamental structures for cells and virus alike.

Estrategia de capacitación para el mejoramiento del autocuidado en familiares cuidadores de enfermos oncológicos / Training strategy for the improvement of self-care in relatives taking care of cancer patients

RESUMEN Introducción: una de las tareas más importantes que compete a los cuidadores, aunque a menudo desatendida, es el autocuidado. Inmersos en las tareas del cuidado, ellos subestiman la atención a los problemas que sufren como consecuencia de su actividad, por lo que es pertinente explorar su nivel de conocimientos sobre este tema. Objetivo: diseñar una propuesta de estrategia de capacitación para el autocuidado a familiares cuidadores de enfermos oncológicos. Materiales y métodos: estudio descriptivo transversal en 25 familiares cuidadores de enfermos oncológicos, en el Policlínico Docente Carlos Verdugo del municipio Matanzas, en el período comprendido entre septiembre y diciembre de 2019. Se utilizaron métodos teóricos: analítico-sintético, inductivo-deductivo e histórico-lógico; y empíricos: Escala de Apreciación de Agencia de Autocuidado, cuestionario para evaluar conocimientos, y una revisión documental a las historias clínicas individuales e historias de salud familiares. Resultados: el 76 % de los familiares cuidadores asociados al cuidado de enfermos oncológicos poseen una capacidad global regular. En relación con las dimensiones bienestar personal, consumo suficiente de alimento, promoción del funcionamiento y desarrollo personal con resultados de regular, se constató la existencia de vacíos de conocimiento para satisfacer las necesidades relacionadas con el autocuidado. Conclusiones: se consideró la necesidad de diseñar una estrategia de capacitación, contentiva de aspectos específicos del autocuidado (AU).

ABSTRACT Introduction: one of the most important tasks competing to caregivers is self-care, although it is frequently neglected. Immersed in the tasks of care, they underestimate the attention to problems they suffer as a consequence of their activity, so it is pertinent to explore their level of knowledge on this matter. Objective: to design a proposal of training strategy for the self-care of relative taking care of cancer patients. Materials and methods: cross-sectional descriptive study in 25 relatives taking care of cancer patients in the Teaching Policlinic Carlos Verdugo, of Matanzas municipality, in the period between September and December 2019. The researchers used theoretical methods: the analytic-synthetic one, the inductive-deductive, and the historical-logical; and empiric methods: the Appraisal of Self-care Agency Scale, a questionnaire to assess knowledge, and a documental review to individual medical records and family health records. Results: 76 % of the family caregivers associated to the care of cancer patients have a regular global capacity. Regarding to personal well-being dimensions, sufficient food consumption, and personal functioning and development showed regular results. It was found the existence of knowledge gaps to satisfy the necessities related with self-care. Conclusions: the need of designing a training strategy contenting specific aspects of self-care was considered (AU).

Caracterización clínico-epidemiológica en pacientes discapacitados visuales por retinosis pigmentaria. Sancti Spíritus. 2009-2019 / Clinical and epidemiological characterization in visual impaired patients due to retinitis pigmentosa. Sancti Spíritus. 2009-2019

RESUMEN Fundamento: La retinosis pigmentaria constituye una causa de discapacidad visual que provoca alteraciones psicológicas y sociales al paciente. Objetivo: Describir las características clínicas y epidemiológicas en pacientes discapacitados visuales por retinosis pigmentaria de la provincia Sancti Spíritus. Metodología: Se realizó un estudio descriptivo, que incluyó 140 pacientes discapacitados visuales afectados por retinosis pigmentaria. Resultados: El grupo etario entre los 29 y 56 años fue el más afectado (78.1 %), el 65 % era del sexo masculino, predominó el color blanco de la piel (87.1 %), sobresalió la catarata como la afección ocular (13.6 %), el 16.4 % presentó hipertensión arterial; la mayoría de los discapacitados no presentó hábitos tóxicos (55 %), prevaleció el debut precoz en el 70 % de los casos. La forma típica de la enfermedad se observó en el 98.5 % de los enfermos, el 67 % manifestó un estadio clínico de la enfermedad grado IV, así como la herencia autosómica recesiva en el 36.4 %. Conclusiones: Predominio de los enfermos en los grupos etario entre 29 y 56 años, masculino, color blanco de la piel; la catarata como patología ocular más frecuente junto a la hipertensión arterial dentro las enfermedades sistémicas; la mayoría de los discapacitados no presentó hábitos tóxicos. El debut precoz, la forma típica, el estadio IV de la enfermedad, así como la herencia autosómica dominante prevalecieron en el estudio.

ABSTRACT Background: Retinitis pigmentosa is a cause of visual impairment that causes psychological and social alterations to the patient. Objective: To describe the clinical and epidemiological characteristics in visual impaired patients due to retinitis pigmentosa in Sancti Spíritus province. Methodology: A descriptive study was carried out, which included 140 visual impaired patients affected by retinitis pigmentosa. Results: The age group between 29 and 56 years old was the most affected (78.1 %), 65 % were male, white skin predominated (87.1 %), cataract stood out as an eye condition (13.6 %), 16.4 % presented arterial hypertension; most of the disabled did not present toxic habits (55 %), early debut prevailed in 70 % of cases. The typical form of the disease was observed in 98.5 % of patients, 67 % showed a clinical stage of grade IV disease, as well as autosomal recessive inheritance in 36.4 %. Conclusions: Prevalence of patients in the age groups between 29 and 56 years, male, white skin color; cataract as the most frequent ocular pathology together with arterial hypertension within systemic diseases; the majority of the disabled patients did not show toxic habits. Early debut, typical form, stage IV disease, and autosomal dominant inheritance prevailed in the study.

Feasibility of two modes of treatment delivery for child anxiety in primary care.

In this study, we examine the feasibility of cognitive behavior therapy (CBT) for children with anxiety in primary care, using two modes of treatment delivery. A total of 48 parents and youth (8-13) with anxiety disorders were randomly assigned to receive 10-sessions of CBT either delivered by a child anxiety specialist in the primary care clinic or implemented by the parent with therapist support by telephone (i.e., face-to-face or therapist-supported bibliotherapy). Feasibility outcomes including satisfaction, barriers to treatment participation, safety, and dropout were assessed. Independent evaluators, blind to treatment condition, administered the Anxiety Disorders Interview Schedule for Children (ADIS) and the Clinical Global Impression of Improvement (CGI-I) at baseline, post-treatment and 3-month follow-up; clinical self-report questionnaires were also administered. Findings revealed high satisfaction, low endorsement of barriers, low drop out rates, and no adverse events across the two modalities. According to the CGI-I, 58.3%-75% of participants were considered responders (i.e., much or very much improved) at the various time points. Similar patterns were found for remission from "primary anxiety disorder" and "all anxiety disorders" as defined by the ADIS. Clinically significant improvement was seen on the various parent and child self-report measures of anxiety. Findings suggest that both therapy modalities are feasible and associated with significant treatment gains in the primary care setting. (clinicaltrials.gov unique identifier: NCT00769925).

Profilaxis de la endoftalmitis posquirúrgica con cefuroxima intracamerular / Prophylaxis of postoperative endophthalmitis with intracamerular cefuroxime

RESUMEN Fundamento: La cirugía de catarata es la intervención oftalmológica más realizada en el mundo con exitosos resultados visuales posoperatorio, por lo cual una endoftalmitis posquirúrgica es una de las complicaciones más temidas y devastadoras. Objetivo: Caracterizar los pacientes operados de catarata a los cuales se les administró cefuroxima intracameral como método profiláctico para la endoftalmitis posquirúrgica durante los primeros 6 meses de su aplicación. Metodología: Se realizó un estudio retrospectivo en el Hospital Provincial General Camilo Cienfuegos de Sancti Spíritus del 15 de octubre de 2015 al 15 de abril de 2016. El universo estuvo constituido por 575 pacientes operados de cirugía de cataratas y la muestra por 538 pacientes a los cuales se les aplicó cefuroxima intracamerular como método profiláctico. Resultados: Se incluyeron 538 pacientes de ellos 279 mujeres y 259 hombres con edad promedio de 46 a 60 años. Se presentaron complicaciones en 21 ojos. En ningún paciente se diagnosticó síndrome inflamatorio tóxico asociado al uso de medicamentos intraoculares. Se reportó un solo caso de endoftalmitis al cual se le realizó extracción extracapsular. Conclusiones: La inyección de cefuroxima intracameral es una maniobra sencilla, eficaz y segura para la profilaxis de la endoftalmitis posquirúrgica.

ABSTRACT Background: Cataract surgery is the most performed ophthalmologic intervention in the world with successful postoperative visual results, so a postoperative endophthalmitis is one of the most feared and devastating complications. Objective: To characterize cataract surgery patients who were given intracameral cefuroxime as a prophylactic method of postoperative endophthalmitis during the first 6 months of its application. Methodology: A retrospective study was carried out at Camilo Cienfuegos General Provincial Hospital in Sancti Spíritus from October 15, 2015 to April 15, 2016. The universe consisted of 575 patients operated on from cataract surgery with a sample of 538 patients which were applied intracamerular cefuroxime as a prophylactic method. Results: 538 patients were included, 279 women and 259 men with an average age of 46 to 60 years. There were complications in 21 eyes. In no patient was toxic inflammatory syndrome associated with the use of intraocular medications. A single case of endophthalmitis was reported and extracapsular extraction was performed. Conclusions: The injection of intracameral cefuroxime is a simple, effective and safe maneuver for the prophylaxis of postoperative endophthalmitis.

Effect of the ADIPOQ Gene -11391G/A Polymorphism Is Modulated by Lifestyle Factors in Mexican Subjects.

BACKGROUND/AIMS: Single nucleotide polymorphisms (SNPs) in the ADIPOQ gene could explain the adiponectin level. However, the knowledge about the influence of genetic and lifestyle factors is not sufficient. The aim was to analyze whether the effect of the -11391G/A SNP in the ADIPOQ gene is modulated by lifestyle factors in Mexican subjects. METHODS: A cross-sectional study was performed in which 394 participants were analyzed. Genetic, anthropometric, biochemical, dietary, clinical and physical activity parameters were measured. Statistical analysis was performed with SPSSv19 software. RESULTS: The distribution of the -11391G/A SNP genotypes was 55.6 and 44.4% for GG and AG, respectively. The adiponectin level was modulated by the -11391G/A SNP in response to the body mass index (BMI); A allele carriers showed a higher adiponectin level compared to G homozygous carriers but only in the minor BMI tertile group (p=0.032). Adiponectin level variability was explained by gender [(r)=1.5, 95% CI 1.1-1.9, p=0.000], insulin resistance [(r)=-1.2, 95% CI -0.8 to -1.6, p=0.000], physical activity [(r)=0.6, 95% CI 0.2-0.9, p=0.002] and monounsaturated fat intake [(r)=0.5, 95% CI 0.38-1.0, p=0.047]. CONCLUSIONS: The adiponectin level was modulated by the interaction between BMI and -11391G/A SNP; this suggests that the lifestyle rather than genetic factors modulates serum adiponectin.

Apuntes sobre la historia de la enfermería en Matanzas, desde 1850 hasta la primera mitad del siglo xx / Notes on the history of nursing in Matanzas, from 1850 until the first half of the 20th century

El presente trabajo forma parte de una investigación histórica a la que se le aplicó un corte descriptivo. En un primer momento se abordaron diferentes hechos de la historia de la enfermería en Matanzas, desde 1850 hasta la primera mitad del siglo xx. La información se recolectó en el Archivo Histórico de la ciudad, la biblioteca Gener y del Monte, el Centro de Documentación, el Museo Palacio de Junco, en entrevistas a enfermeras e historiadores, desde septiembre del 2015 hasta abril del 2016. Ello nos permitió obtener información relacionada con la fundación de los Hospitales en Matanzas y las actividades de Enfermería que en ellos se desarrollaban. Se hizo una búsqueda de la presencia de las religiosas en los hospitales, fundamentalmente de Matanzas y los términos municipales principales; entre ellas se encontraban las Hermanas de la Caridad, las que desarrollaron actividades de enfermería en hogares de ancianos, hospitales y en visitas preventivas, y más tarde las Siervas de María. Se constató el surgimiento de la enfermería profesional en Cuba, a partir de la intervención estadounidense. En Matanzas, se crea la primera Escuela de Enfermeras en 1900. En la primera década del siglo xx, fungieron como superintendentes las estadounidenses Miss Eugenie Habbard en 1900 y Miss Mary McCLloud, en 1902. Se ofrecen algunos datos preliminares, ya que se trata de una investigación histórica que tiene el objetivo de dejar constancia del interesante legado histórico en Matanzas desde 1850 hasta nuestros días (AU).

The current work is a part of a descriptive historic research. Several facts of the history of nursing in Matanzas were dealt with in a first moment, from 1850 until de first half on the 20th century. The information was collected in the Historical Record Office of the province, the library "Gener y del Monte", the Documentation Centre, and the Museum Palacio de Junco, in interviews to nurses and historians, from September 2015 to April 2016. It allowed us to obtain information on the foundation of the hospitals in Matanzas and the nursing activities developed in them. A search was made in regard to the presence of nuns in the hospitals, mainly in Matanzas and the most important municipalities; among them were found the Sisters of Charity, who performed their nursing activities in old people's nursing homes, hospitals and preventive visits, and later the Servants of Mary. It was stated the begining of the professional nursing in Cuba from the times of the USA intervention. In Matanzas, the School of Nurses was created in 1900. In the first decade of the 20th century Miss Eugenie Habbard acted as supervisor in 1900 and Miss Mary McCloud in 1902. We offer several preliminary data because this is a historical research having as an objective leaving some token of the interesting historical legacy of nursing in Matanzas from 1850 to the present days (AU).

Effect of Ala54Thr polymorphism of FABP2 on anthropometric and biochemical variables in response to a moderate-fat diet.

OBJECTIVE: To analyze the effect of the fatty acid-binding protein (FABP2) gene Ala54Thr polymorphism on anthropometric and biochemical variables in response to a moderate-fat diet in overweight or obese subjects. METHODS: One hundred nine subjects with a body mass index ≥ 25 kg/m(2) were studied. Participants underwent a dietary intervention that consisted of 30% fat (saturated fat <7% of total calories), 15% protein, and 55% carbohydrates. The FABP2 genotypes were analyzed by polymerase chain reaction-restriction fragment length polymorphism. Anthropometric and biochemical data were measured at baseline, 1 mo, and 2 mo of nutritional intervention. RESULTS: The mean age was 38.6 ± 11.3 y and the mean body mass index 32.7 ± 6.1 kg/m(2), with 20 men (18%) and 89 women (82%). Fifty-three patients (48.6%) had genotype Ala54Ala (wild-type group) and 56 patients had genotype Ala54Thr/Thr54Thr (51.4%, mutant group). At baseline, no significant difference was found between the FABP2 genotypes groups, except for the carbohydrate intake and resting metabolic rate, which were higher in the Ala54Thr/Thr54Thr group (P < 0.05). At 2 mo, participants had lost 6.8% of their initial weight. The Ala54Thr/Thr54Thr group compared with the Ala54Ala group showed significant decreases in the parameters of weight (-7.5 versus -4.2 kg), body mass index (-2.1 versus -1.2 kg/m(2)), waist circumference (-7.6 versus -5.2 cm), waist-to-hip ratio (-0.04 versus -0.02), and C-reactive protein (-1.4 versus -0.76 mg/L), respectively (P < 0.05). After the resting metabolic rate was adjusted, the decreases in waist circumference, waist-to-hip ratio, and C-reactive protein remained significant between the two groups. CONCLUSIONS: This study showed that the Thr54 allele carriers responded better to a moderate-fat diet.

Extracción de catarata mediante la técnica de facoemulsificación con implante de lente intraocular / Cataract´s extraction by phacoemulsification´s technique with intraocular lens

Fundamento: La facoemulsificación es la técnica quirúrgica más aceptada en la actualidad para la cirugía de catarata Objetivo: Describir los resultados de la cirugía de catarata mediante la técnica de facoemulsificación. Metodología: Se realizó un estudio descriptivo, longitudinal y prospectivo en 115 ojos de pacientes con diagnóstico de catarata operados en el Hospital General Provincial Camilo Cienfuegos, entre julio 2009 y agosto 2015. Se analizaron las variables: edad, sexo, tipo de catarata, agudeza visual sin corrección y mejor corregida, tipo de lente intraocular empleado y posición del mismo, complicaciones transoperatorias y posoperatorias. Resultados: El grupo etario que prevaleció fue el de 60 años y más con 47 %, hubo un predominio de féminas sobre masculinos para un 55,7 %; se halló un 53 % de catarata relacionada con la edad, se encontró un 45,2 % de pacientes con agudeza visual preoperatoria de 0.1 a 0.3 de visión; en cuanto a la agudeza visual posoperatoria, a los siete días ya un 13 % alcanzó la unidad de visión, situación que cambió al mes con un 27 %; ya con la agudeza visual mejor corregida se observó un 86,1 % de pacientes con una visión de 1.0 y con visión de 0.8 a 0.9 para un 6,8 %, lo que evidenció la mejoría en la misma. La complicación transoperatoria más frecuente fue el surge y la posquirúrgica, la opacidad de cápsula posterior, aunque en ambos casos el mayor por ciento de pacientes no las presentó. Conclusiones: Se constató una mejoría importante de la agudeza visual sin corregir y con corrección después de la cirugía con un menor número de complicaciones